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Cat scratch fever is the common name for cat scratch disease (CSD), an infection caused by the bacterium Bartonella henselae. A scratch can lead to a small bump, fever, and tender lymph nodes one to three weeks later, but the CDC says most cat scratches do not result in CSD. The usual illness is mild and resolves on its own. The practical response is to wash the wound promptly, watch for symptoms, seek medical advice if they appear or if you are immunocompromised, and work with your veterinarian on flea control rather than trying to test or treat a healthy cat.
1. What is cat scratch disease?
Cat scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae, a bacterium associated with cats and fleas. “Cat scratch fever” is a colloquial name, but fever is only one possible symptom and is not required for diagnosis. The infection most often follows a scratch from a domestic or feral cat, especially a kitten, when flea feces contaminate broken skin.
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For people, the relevant question is whether symptoms develop after an exposure. For cats, infection with B. henselae is often unapparent; a healthy cat should not automatically be tested or given antibiotics.
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CDC’s overview of cat scratch disease explains the basic cause, exposure routes, symptoms, and prevention measures.
2. How do cats and people get Bartonella?
Fleas are central to the transmission cycle. Cats commonly acquire B. henselae through bites from infected fleas. A cat can then carry flea feces in its fur or under its claws. If those contaminated particles enter a scratch, bacteria may reach a person’s skin.
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Cats can acquire the bacterium through fights with infected cats and, less commonly, through feline blood transfusions. Transmission is more likely where cats and fleas live together, which is why flea prevention matters even for an indoor cat that never roams.
Do not assume a visibly healthy cat is free of Bartonella. CDC’s veterinary guidance says that healthy animals generally do not need testing or treatment solely because they may have been exposed.
3. What are the symptoms of cat scratch fever, and when do they start?
The first noticeable sign may be a small papule or pustule at the scratch site. A low-grade fever can occur. One to three weeks after exposure, tender, enlarged lymph nodes commonly develop near the affected area—for example, in the armpit after a hand or arm scratch.
The timing is not exact. The California Department of Public Health describes swollen nodes appearing within roughly one to four weeks. Nodes can remain enlarged for two to four months, with or without antibiotics, even after a person otherwise feels well.
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Symptoms can be subtle, especially in adults. A person may remember a minor scratch only after a lymph node becomes sore. Conversely, a scratch without a bump, fever, or swollen nodes does not prove that CSD is developing.
Contact a healthcare provider if you develop fever, a pustule at the exposure site, or tender swollen lymph nodes after a cat scratch. Mention the cat exposure, the date, the body location, and whether the cat is a kitten or has a flea problem.
4. Is cat scratch disease dangerous?
Usually, no. Most cases are self-limited, meaning the immune system clears the infection without a serious outcome. However, uncommon complications can involve the eye, liver, spleen, brain, bones, or heart valves.
Severe or atypical disease deserves particular attention in people with weakened immune systems. Immunocompromise can result from certain illnesses, cancer treatment, transplant medicines, or other immune-suppressing therapy. If that applies to you, call your healthcare provider promptly after concerning symptoms rather than waiting for them to resolve.
Seek urgent medical care for severe headache, confusion, fainting, new weakness, vision changes, chest symptoms, persistent high fever, or significant abdominal pain after a possible exposure. Those symptoms have many possible causes, but they are not appropriate for watchful waiting without professional assessment.
Children under 15 are disproportionately affected according to CDC data. CSD occurs wherever cats and fleas are found together, and CDC reports that most U.S. cases occur in fall and winter.
5. How common is Bartonella in cats?
Cat infection is more common than symptomatic human CSD, but the figures must be interpreted carefully. CDC’s 2026 veterinary guidance reports that 30–40% of domestic and adopted shelter cats have documented B. henselae bacteremia. That is a measure of bacteria detected in cats in the cited context—not a claim that every cat is ill, infectious at every moment, or likely to cause human disease.
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A Cornell University College of Veterinary Medicine explainer gives a broader estimate of approximately 40% of cats infected with B. henselae. Because the page’s publication date was not established in the reviewed material, CDC’s current 30–40% bacteremia estimate is the more specific figure to use.
There is no national human-incidence number in CDC’s public overview, so a precise annual count should not be inferred from cat-infection estimates. A high prevalence of exposure among cats does not mean that a scratch will cause illness.
6. How is cat scratch disease diagnosed?
For a typical case, clinicians usually rely on the pattern of symptoms plus a compatible cat exposure. A scratch or bite followed by a local lesion and nearby lymph-node swelling is often enough to support a clinical diagnosis.
Laboratory testing is generally unnecessary in straightforward illness. It becomes more useful when disease is severe, atypical, prolonged, or affecting an unusual organ. Serology can support a diagnosis, but antibodies may cross-react with other Bartonella species and can remain detectable for years, so a positive result does not always prove that a recent scratch caused current symptoms.
PCR can detect bacterial DNA from a lymph-node aspirate or blood, although blood testing does not have optimal sensitivity. Lymph-node aspiration is not routinely recommended. CDC describes it mainly for relieving severe, painful swelling or when the diagnosis remains unclear.
Do not order a test for yourself solely because a cat scratched you. Testing decisions belong with a healthcare professional who can interpret the result alongside your examination and exposure history.
7. Does cat scratch disease need antibiotics?
Not automatically. Most otherwise healthy people recover without antibiotic treatment. CDC says clinicians may consider antibiotics according to immune status, disease severity, clinical presentation, and patient–provider preference.
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CDC cites a small study in which a short course of azithromycin reduced lymph-node volume more quickly, but overall health outcomes did not differ between treated and untreated groups. That finding does not make azithromycin a guaranteed cure or a routine requirement, and it is not a reason to self-medicate.
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Antibiotics are recommended for immunocompromised patients, while treatment for an otherwise healthy person is individualized. A clinician may also investigate other causes of swollen nodes or fever before deciding that CSD is the explanation.
For a cat, the advice is different. CDC does not recommend testing or treating a healthy animal for B. henselae simply to prevent human disease. A cat with fever lasting more than three days, vomiting, lethargy, red eyes, swollen lymph nodes, or reduced appetite should be examined by a veterinarian. Veterinary treatment decisions depend on the cat’s signs and overall health.
8. How can you prevent cat scratch disease?
Prevention is practical risk reduction, not avoidance of cats. The most useful measures are:
- Clean every scratch or bite immediately. Rinse and wash the area thoroughly with soap and running water. Seek medical advice for deep wounds, spreading redness, drainage, severe pain, or uncertain tetanus status.
- Wash your hands after handling cats. This is especially important after contact with kittens, outdoor cats, or anything that may contain flea dirt.
- Avoid rough play. Do not encourage wrestling with hands, and avoid provoking a cat that is frightened or agitated. Do not allow a cat to lick an open wound.
- Control fleas with veterinary guidance. Ask your veterinarian which flea-prevention product is appropriate for your cat’s age, weight, health, and household. Never use a product containing permethrin on a cat; permethrin can be toxic to cats.
- Reduce exposure to strays and fights. Keeping cats indoors and away from stray animals lowers opportunities for flea exposure and bite wounds.
- Use extra caution if immunocompromised. CDC says people with immunocompromising conditions can still own cats, but they should avoid acquiring cats younger than one year and should discuss safe handling with their healthcare provider.
Declawing is not a CSD-prevention strategy. It is an irreversible procedure with welfare and medical consequences and does not address flea-associated transmission.
What should you do immediately after a cat scratch?
Start with wound care, then monitor rather than panic. Wash the scratch with soap and water, apply gentle pressure if it is bleeding, and keep the area clean. Do not scrub aggressively, pour harsh chemicals into the wound, or assume an antibiotic is needed.
Over the next several weeks, watch for a bump or pustule at the site, fever, or tender lymph nodes. Write down when the scratch happened and where it occurred; that information helps a clinician judge timing. Call a healthcare provider if those symptoms appear, if they persist, or if you have a weakened immune system.
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For the cat, check for fleas and arrange veterinary advice about prevention. Do not attempt to diagnose Bartonella from the scratch alone, and do not give a healthy cat antibiotics without a veterinarian’s direction.
Human symptoms and cat symptoms are not the same
A person with CSD may have a lesion at the exposure site and swollen regional lymph nodes. A cat carrying B. henselae may show no signs at all. When cats are ill, CDC lists prolonged fever, vomiting, lethargy, red eyes, swollen lymph nodes, and poor appetite as reasons for veterinary evaluation.
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1Scan for outdated or missing drivers - takes under a minute2Clear out junk files and repair common Windows errors3Fix the driver behind crashes, sound loss and screen glitchesThat distinction prevents two common errors: assuming a healthy-looking cat cannot carry the bacterium, or assuming a cat must be treated because a household member was scratched. Human care belongs with a healthcare provider; concerning animal signs belong with a veterinarian.
Key takeaway
Cat scratch fever is a real but usually mild infection linked to Bartonella henselae and flea contamination. Most scratches do not cause disease. Wash wounds promptly, control fleas with veterinary advice, watch for the characteristic delayed symptoms, and seek medical care for concerning or severe illness—especially if your immune system is weakened.
Sources
- CDC: About Cat Scratch Disease (September 11, 2026)
- CDC: Clinical Overview of Cat Scratch Disease (March 23, 2026)
- CDC: Veterinary Guidance for Bartonellosis (March 23, 2026)
- Cornell University College of Veterinary Medicine: Zoonotic Disease
- California Department of Public Health: Cat Scratch Disease
Frequently Asked Questions
Can an indoor cat give me cat scratch disease?
Yes, an indoor cat can still be exposed to fleas, although indoor living may reduce some risks. Indoor status does not replace veterinarian-guided flea prevention, and a cat’s appearance cannot determine whether it has carried Bartonella.
How long should a swollen lymph node after a scratch last?
Swollen nodes may take two to four months to return to normal, according to California public-health guidance. Worsening pain, persistent fever, or new symptoms should prompt medical review rather than waiting for the node to shrink.
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Should I get my cat tested after it scratches me?
Not if the cat is healthy and the only concern is the scratch. CDC does not recommend routine testing or treatment of healthy cats for Bartonella; testing is a veterinary decision when the animal has concerning signs.
Can cat scratch disease spread from one person to another?
Routine person-to-person spread is not the usual pattern described in public-health guidance. The recognized concern is exposure to infected cats, flea contamination, bites, scratches, or licking of an open wound.
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